Balanced anesthetic techniques in dogs and cats

The term "balanced anesthesia" refers to the use of a mixture of drugs, such that the advantages of small amounts of drugs are used without having to contend with the disadvantages of large doses of any one drug. In veterinary practice, inhalant drugs are usually administered alone to maintain anesthesia, and balanced anesthetic techniques are rare. Unfortunately, cardiopulmonary function is reduced in dose-dependent fashion by inhalant drugs and deepening the level of anesthesia in order to modify autonomic responses to noxious stimuli may increase morbidity and mortality. This article justifies the use of balanced anesthetic techniques in veterinary practice and describes the advantages gained by the use of nitrous oxide, continuous opioid infusion, epidural/spinal opioid administration, and transdermal opioid administration. These techniques, described in detail in the article, are easy to learn, relatively inexpensive, may decrease patient morbidity and mortality, and will provide the veterinarian with smoother operating conditions.     

Detomidine reduces isoflurane anesthetic requirement (MAC) in horses

Objective To quantitate the dose‐ and time‐related magnitude of the anesthetic sparing effect of, and selected physiological responses to detomidine during isoflurane anesthesia in horses. Study design Randomized cross‐over study. Animals Three, healthy, young adult horses weighing 485 ± 14 kg. Methods Horses were anesthetized on two occasions to determine the minimum alveolar concentration (MAC) of isoflurane in O₂ and then to measure the anesthetic sparing effect (time‐related MAC reduction) following IV detomidine (0.03 and 0.06 mg kg^?1). Selected common measures of cardiopulmonary function, blood glucose and urinary output were also recorded. Results Isoflurane MAC was 1.44 ± 0.07% (mean ± SEM). This was reduced by 42.8 ± 5.4% and 44.8 ± 3.0% at 83 ± 23 and 125 ± 36 minutes, respectively, following 0.03 and 0.06 mg kg^?1, detomidine. The MAC reduction was detomidine dose‐ and time‐dependent. There was a tendency for mild cardiovascular and respiratory depression, especially following the higher detomidine dose. Detomidine increased both blood glucose and urine flow; the magnitude of these changes was time‐ and dose‐dependent Conclusions Detomidine reduces anesthetic requirement for isoflurane and increases blood glucose concentration and urine flow in horses. These changes were dose‐ and time‐related. Clinical relevance The results imply potent anesthetic sparing actions by detomidine. The detomidine‐related increased urine flow should be considered in designing anesthetic protocols for individual horses.     

A preliminary trial comparison of several anesthetic techniques in cats

The aim of this study was to investigate the effect of several drug combinations (atropine, xylazine, romifidine, methotrimeprazine, midazolam, or fentanyl) with ketamine for short term anesthesia in cats. Twelve cats were anesthetized 6 times by using a cross-over Latin square protocol: methotrimeprazine was combined with midazolam, ketamine, and fentanyl; midazolam and ketamine; romifidine and ketamine; and xylazine and ketamine. Atropine was combined with romifidine and ketamine, and xylazine and ketamine. Temperature, heart rate, and respiratory rate decreased in all groups. Apnea occurred in 1 cat treated with methotrimeprazine, romifidine, and ketamine, suggesting that ventilatory support may be necessary when this protocol is used. Emesis occurred in some cats treated with alpha 2-adrenoceptor agonists, and this side effect should be considered when these drugs are used.     

Comparison of two intravenous anesthetic infusion regimens for alfaxalone in cats

Objective

To compare the performance of an alfaxalone constant rate intravenous (IV) infusion versus a 3-step IV infusion, both following a loading dose, for the maintenance of a target plasma alfaxalone concentration of 7.6 mg L^–1 (effective plasma alfaxalone concentration for immobility in 99% of the population) in cats.

Effects of opioids and anesthetic drugs on body temperature in cats

ObjectiveTo determine which class of opioid alone or in conjunction with other anesthetic drugs causes post-anesthetic hyperthermia in cats.Study designProspective, randomized, crossover study.AnimalsEight adult, healthy, cats (four spayed females and four castrated males weighing 3.8 ± 0.6 kg).MethodsEach cat was instrumented with a wireless thermistor in the abdominal cavity. Temperature in all phases was recorded every 5 minutes for 5 hours. Population body temperature (PBT) was recorded for ～8 days. Baseline body temperature is the final 24 hours of the PBT. All injectable drugs were given intramuscularly. The cats were administered drugs in four phases: 1) hydromorphone (H) 0.05, 0.1, or 0.2 mg kg^?1; 2) morphine (M) (0.5 mg kg^?1), buprenorphine (BUP) (0.02 mg kg^?1), or butorphanol (BUT) (0.2 mg kg^?1); 3) ketamine (K) (5 mg kg^?1) or ketamine (5 mg kg^?1) plus hydromorphone (0.1 mg kg^?1) (KH); 4) isoflurane in oxygen for 1 hour. Fifteen minutes prior to inhalant anesthetic, cats received either no premed (I), hydromorphone (0.1 mg kg^?1) (IH), or hydromorphone (0.1 mg kg^?1) plus ketamine (5 mg kg^?1) (IHK).ResultsMean PBT for all unmedicated cats was 38.9 ± 0.6 °C (102.0 ± 1 °F). The temperature of cats administered all doses of hydromorphone increased from baseline (p < 0.03) All four opioids (H, M, BUP and BUT) studied increased body temperature compared with baseline (p < 0.005). A significant difference was observed between baseline temperature values and those in treatment KH (p < 0.03). Following recovery from anesthesia, temperature in treatments IH and IHK was different from baseline (p < 0.002).Conclusions and clinical relevanceAll of the opioids tested, alone or in combination with ketamine or isoflurane, caused an increase in body temperature. The increase seen was mild to moderate (<40.1 °C (104.2 °F) and self limiting.     

Effect of acepromazine on the anesthetic requirement of halothane in the dog

Five adult dogs were used to determine whether acepromazine maleate (ACP), administered IM, decreases the maintenance requirement of halothane and to measure any decrease for the ACP dosages of 0.02, 0.04, 0.06, 0.08, 0.10, and 0.20 mg/kg. The value minimal alveolar concentration, a measure of anesthetic potency, was used as the measure of anesthetic requirement of halothane before and after ACP was administered. All dogs were randomly exposed to each dosage of ACP, as well as to control of 0.2 ml of sterile water. At all dosages of ACP, the decrease in the minimal alveolar concentration of halothane was significant (P less than or equal to 0.05) when compared with that of the control. The decreases at the 0.04 and 0.20 mg/kg dosages were significantly (P less than or equal to 0.05) greater than those at the 0.02 and 0.06 mg/kg dosages. Halothane requirements at all other ACP dosages (0.08 and 0.10 mg/kg) were not significantly different from each other or from those at any of the other dosages. The percentage of decrease in anesthetic requirement after ACP was administered varied from 34% to 46%, with a mean decrease of 40%. The largest decrease was recorded at the dosage of 0.04 mg/kg.     

Effects of a standardized anesthetic protocol on hematologic variables in healthy cats

This study evaluated the effects of an anesthetic protocol using intravenous ketamine and midazolam, and intramuscular buprenorphine on hematologic variables in cats. Twelve healthy adult cats had blood collected for a complete blood count before and after the induction of anesthesia. There were significant decreases in red blood cell counts, hemoglobin concentrations and hematocrits after the induction of anesthesia. On average, red blood cell counts and hematocrits decreased by 25%, and hemoglobin concentrations decreased by 24%. Based on hematocrit, 3/12 samples (25%) taken while the cats were anesthetized would have been interpreted as belonging to anemic patients while none of the cats would have been considered anemic before anesthesia. This study suggests that a complete blood count performed on blood taken under anesthesia with this anesthetic protocol should be interpreted cautiously in order to not make a false diagnosis of anemia.     

Clinical usefulness of propofol as an anesthetic induction agent in dogs and cats

Propofol was used as an induction agent of general anesthesia in 77 dogs and 64 cats, all client owned, for a variety of surgeries/treatments or diagnostic procedures. The mean intravenous doses of propofol required to achieve endotracheal intubation in dogs and cats were 6.5 +/- 1.4 mg/kg and 10.1 +/- 2.8 mg /kg, respectively. Most of the animals could be induced to anesthesia smoothly by the administration of propofol with a high incidence of apnea. Propofol is a clinically valuable anesthetic induction agent in both dogs and cats, however, care must be taken for apnea.     

Comparison of anesthetic induction in cats by use of isoflurane in an anesthetic chamber with a conventional vapor or liquid injection technique

OBJECTIVE: To compare 2 techniques for induction of cats by use of isoflurane in an anesthetic chamber. DESIGN: Prospective, randomized study. ANIMALS: 51 healthy cats. PROCEDURES: Cats were randomly allocated to 2 induction techniques. Cats were premedicated with acepromazine (0.1 mg/kg [0.045 mg/lb], SC) and buprenorphine (0.01 mg/kg [0.0045 mg/lb], SC) 30 minutes before induction. Cats were then placed into an induction chamber, and anesthetic induction was initiated. One technique involved a conventional flow-through system that used an oxygen flowmeter and an isoflurane vaporizer to flow vapors into the induction chamber. Alternatively, liquid isoflurane was injected into a vaporization tray that was mounted to the interior surface of the chamber lid. Inductions were videotaped for analysis. Five variables (head bobbing, head swinging side to side, paddling, rotating 180 degrees to 360 degrees, and rolling over or flipping) were scored to assess induction quality. Time variables recorded during induction corresponded to the interval until onset of excitatory motion, duration of excitatory motion, interval until recumbency, and interval until complete induction. RESULTS: Compared with cats anesthetized by use of a conventional vapor chamber technique, cats anesthetized by use of the liquid injection technique had a significantly shorter interval until recumbency and interval until complete induction and lower scores for quality of induction, indicating a smoother induction. CONCLUSIONS AND CLINICAL RELEVANCE: Anesthetic induction in cats by use of a liquid injection technique was more rapid and provided a better quality of induction, compared with results for cats induced by use of a conventional vapor technique.     

猫狗的营养需求及饲料开发问题探讨

本文根据美国饲料监察联盟机构（AAFCO）2000年提出的猫狗营养需要草案，结合我国现阶段宠物猫狗的营养研究状况、饲料开发中存在的问题和研究开发思路作一简单探讨，以期起到抛砖引玉的作用。     

A comparison of anesthetic and cardiorespiratory effects of tiletamine-zolazepam-butorphanol and tiletamine-zolazepam-butorphanol- medetomidine in cats

Using a randomized crossover design, this study compared the anesthetic and cardiorespiratory effects of three intramuscular anesthetic combinations in seven 2-year-old cats: tiletamine-zolazepam (8 mg/kg) and butorphanol (0.2 mg/kg) (TT); tiletamine-zolazepam (3 mg/kg), butorphanol (0.15 mg/kg), and medetomidine (15 microg/kg) (TTD); or the TTD protocol plus atipamezole (75 microg/kg IM) given 20 minutes later to reverse medetomidine. Analgesia was assessed using algometry and needle pricking. All three combinations effectively induced anesthesia suitable for orotracheal intubation within 5 minutes after injection. Hemoglobin oxygen saturation was lower than 90% at least once in all three groups between 5 and 15 minutes after drug administration. Blood pressure and heart and respiratory rates were within normal ranges. Both TT and TTD appeared to be effective injectable anesthetic combinations. TTD provided significantly better analgesia with a longer duration than did TT. Atipamezole administration shortened the duration of analgesia and decreased blood pressure but did not shorten total recovery time.     

The cardiorespiratory and anesthetic effects of clinical and supraclinical doses of alfaxalone in cats

ObjectiveTo determine the cardiorespiratory and anesthetic effects of 0, 5, 15, and 50 mg kg^?1 intravenous (IV) alfaxalone in hydroxypropyl beta cyclodextrin (Alfaxan; Jurox Pty Ltd, Rutherford, NSW, Australia) in cats.Study designFour treatments of alfaxalone were administered in sequential order.AnimalsEight healthy adult cats (four male; four female) weighing between 3.71 and 5.91 kg.MethodsCats were instrumented for hemodynamic measurements. Four (0, 5, 15, and 50 mg kg^?1) IV doses of alfaxalone were administered over one minute, with a 3-hour washout period between doses 0, 5, and 15 mg kg^?1 on Day 0. The 50 mg kg^?1 treatment was administered 24 hours later. Measurements of heart rate, aortic systolic, mean, and diastolic blood pressures, pulmonary arterial and right atrial mean pressures, cardiac output, respiratory rate, tidal and minute volumes, and arterial blood pH and blood gases (PaO₂, PaCO₂) were performed at pre-determined intervals. Systemic vascular resistance and rate pressure product were calculated. The quality of induction, maintenance, and recovery from anesthesia and the response to noxious stimulation were categorically scored.ResultsAlfaxalone administration resulted in dose-dependent cardiorespiratory depression. Decreases in arterial blood pressure and increases in heart rate occurred at higher doses. Most variables returned to baseline by 15-30 minutes. Respiratory rate, minute volume, and PaO₂ decreased. Apnea was the most common side effect. Induction and maintenance quality were judged to be good to excellent at all doses and quality of recovery good to excellent at all but the 50 mg kg^?1 dose. The duration of anesthesia and unresponsiveness to noxious stimulation increased with dose. The administration of the 50 mg kg^?1 dose produced marked cardiorespiratory depression and apnea.Conclusions and clinical relevanceAlfaxalone produced dose-dependent anesthesia, cardiorespiratory depression and unresponsiveness to noxious stimulation in unpremedicated cats. Hypoventilation and apnea were the most common side effects.     

Quantitative characteristics of anesthetic induction with and recovery from isoflurane and sevoflurane in cats

Isoflurane (ISO) is the most commonly administered feline inhalant anesthetic in North America. A newer agent, sevoflurane (SEVO), may provide faster induction and recovery from anesthesia based on its physical characteristics. Accordingly, we compared some induction and recovery characteristics of ISO and SEVO in healthy cats. Six female DSH cats (17.9 ± 9.0 (mean ± SD) months, 3.7 ± 0.3 kg) received four randomly assigned treatments: ISO for 1 hour (IS), SEVO for 1 hour (SS), ISO for 5 hours (IL), and SEVO for 5 hours (SL). Anesthesia was induced in a chamber into which ISO or SEVO was delivered at 2.7 times the individual's MAC (determined previously) in 6 L minute^?1 O₂. Measured (Rascal II, Ohmeda) anesthetic concentration was reported after correction using a multiple gas, standard‐defined calibration curve. For induction, time (seconds) from introduction of inhalant to onset of incoordinated movement (IM), recumbency with movement (RM), recumbency without movement, loss of pedal reflex (PD), and intubation (ET) were recorded. Following intubation, anesthesia was maintained for the required time at 1.25 times the individual's MAC. For recovery, time (seconds) from discontinuation of the inhalant (with continuation of O₂) to first movement, extubation (EXT), start of incoordinated movement, head‐lift, sternal recumbency (SR), crawl, stand/walk with incoordination, and jump without incoordination were recorded. Esophageal normothermia was maintained. Data were analyzed by paired t‐test (induction) or One‐way Repeated Measures anova followed, when appropriate, by Tukey's test (recovery). p < 0.05 was regarded as significant. For induction, IM was not significantly different between ISO and SEVO (118 ± 28 seconds vs. 104 ± 28 seconds). All other induction times were significantly shorter with SEVO vs. ISO, e.g. RM (181 ± 31 seconds vs. 213 ± 31 seconds), PD (426 ± 68 seconds vs. 504 ± 70 seconds), and ET (434 ± 66 seconds vs. 515 ± 69 seconds). For recovery, there were no differences between ISO and SEVO for any stage of recovery, e.g. EXT (IS 588 ± 163 seconds vs. SS 425 ± 109 seconds), SR (IS 735 ± 215 seconds vs. SS 655 ± 337 seconds), and IL (710 ± 658 seconds vs. SL 807 ± 465 seconds). We concluded that quantitative recovery characteristics did not depend on whether cats are anesthetized with equipotent amounts of SEVO or ISO, but some induction end‐points were reached more quickly with SEVO.     

Comparison of two injectable anesthetic regimes in feral cats at a large-volume spay clinic

Same‐day mass sterilization of feral cats requires rapid onset, short‐duration anesthesia. The purpose of this study was to compare our current anesthetic protocol, Telazol–ketamine–xylazine (TKX) with medetomidine–ketamine–buprenorphine (MKB). Feral female cats received either IM TKX (n = 68; 0.25 mL cat^?1; tiletamine 12.5 mg, zolazepam 12.5 mg, K 20 mg, and X 5 mg per 0.25 mL) or MKB (n = 17; M 40 µg kg^?1, K 15 mg kg^?1, and B 10 µg kg^?1). Intervals measured included time from injection to recumbency, time to surgery, duration of surgery, and time from reversal of anesthesia (TKX: yohimbine 0.50 mg cat^?1 IV; MKB: atipamezole 0.50 mg cat^?1 IM) to sternal recumbency. Following instrumentation (Vet/Ox 4403 and Vet/BP Plus 6500), physiological measurements were recorded at 5‐minute intervals, and included rectal temperature, heart rate (HR), respiratory rate (RR), SpO₂ (lingual or rectal probes), and indirect mean arterial blood pressure (MAP) (oscillometric method). Nonparametric means were compared using Mann–Whitney U‐tests. Parametric means were compared using a two‐factorial anova with Bonferroni's t‐tests. The alpha‐priori significance level was p < 0.05. Values were mean ± SD. Body weight (TKX: 2.9 ± 0.5 kg, MKB: 2.7 ± 0.7 kg), time to recumbency (TKX: 4 ± 1 minutes, MKB: 3 ± 1 minutes), time to surgery (TKX: 28 ± 7 minutes, MKB: 28 ± 5 minutes), and duration of surgery (TKX: 11 ± 7 minutes, MKB: 8 ± 5 minutes) did not differ between groups. In contrast, MKB cats required less time from reversal to sternal recumbency (TKX: 68 ± 41 minutes, MKB: 7 ± 2 minutes) and were recumbent for shorter duration (TKX: 114 ± 39 minutes, MKB: 53 ± 6 minutes). Temperature decreased during the study in both groups, but overall temperature was higher in MKB cats (38.0 ± 0.95 °C) than in TKX cats (37.5 ± 0.95 °C). RR, HR, and SpO₂ did not change during the study in either group. However, overall HR and RR were higher in TKX cats (RR: 18 ± 8 breaths minute^?1, HR: 153 ± 30 beats minute^?1) compared to MKB cats (RR: 15 ± 7 breaths minute^?1, HR: 128 ± 19 beats minute^?1). In contrast, overall SpO₂ was lower in the TKX group (90 ± 6%) compared to the MKB group (94 ± 4%). MAP was also lower in the TKX group (112 ± 29 mm Hg) compared to that in the MKB group (122 ± 20 mm Hg). However, MAP increased in the TKX group during surgery compared to pre‐surgical values, but did not change in the MKB group. The results of this study suggested that MKB might be more suitable as an anesthetic for the purpose of mass sterilization of feral female cats.     

Effect of four sedative and anesthetic protocols on quantitative thyroid scintigraphy in euthyroid cats

OBJECTIVES: To determine the effect of sedation and anesthesia on thyroid and salivary gland uptake of technetium Tc 99m pertechnetate ((99m)TcO(4)) in euthyroid cats. ANIMALS: 6 euthyroid cats. PROCEDURES: Thyroid scintigraphy was performed by use of a high-resolution low-energy parallel-hole collimator after IV injection of 117 to 133 MBq (3.16 to 3.59 mCi) of (99m)TcO(4)(-). The procedure was performed 4 times on each cat during different sedative and anesthetic protocols in a rotating schedule as follows: propofol, ketamine-midazolam-atropine, ketaminemidazolam, and medetomidine. Regions of interest were drawn around thyroid and salivary glands and counts corrected for background and decay. Percentage of (99m)TcO(4)(-) uptake in salivary and thyroid glands and thyroid-to-salivary gland (99m)TcO(4)(-) uptake ratio were calculated at 20 and 40 minutes. Relative effects of anesthesia and sedation on salivary and thyroid gland (99m)TcO(4)(-) uptake were compared. RESULTS: Significant differences among sedativeanesthetic protocols were found for thyroid gland (99m)TcO(4)(-) uptake, salivary gland (99m)TcO(4)(-) uptake, and thyroid-to-salivary gland (99m)TcO(4)(-) uptake ratio. Thyroid gland (99m)TcO(4)(-) uptake for the ketamine-midazolam protocol at 20 and 40 minutes after (99m)TcO(4)(-) administration was significantly higher than for the propofol protocol. A significant difference in salivary gland(99m) TcO(4)(-) uptake was found between ketamine-midazolam and ketamine-midazolam-atropine protocols at 40 minutes. The thyroid-to-salivary gland (99m)TcO(4)(-) uptake ratio for the ketamine-midazolam protocol was significantly higher at 40 minutes than for propofol or ketamine-midazolam-atropine protocols. CONCLUSIONS AND CLINICAL RELEVANCE: Sedation and anesthesia have a significant effect on thyroid and salivary gland (99m)TcO(4) uptake in euthyroid cats that may interfere with thyroid scintigraphic image interpretation.